When a surgical operation is performed by laparoscopy, the patient's abdomen is inflated by a gas and the surgeon uses trocars for the surgical procedure.
A trocar is a cylindrical device that passes through the abdominal wall of the patient and through which the instrument or instruments for performing the surgical operation are passed.
To position these cylindrical trocars, which can have a diameter of 5 to 15 mm, it is necessary to make an incision in the skin and the trocar is inserted into the abdomen with its pointed end, which is provided with protective means. On completion of the surgical operation, the trocar is withdrawn and the orifice through which it was introduced, having a length of about 12 mm, must be closed once again to allow proper healing. If the orifices for passage of trocars are longer than 10 mm, they must be closed by suturing the subcutaneous layers, or in other words the aponeurosis and the muscle, which is the resistant rigid part. Heretofore such orifices were closed by placing a suture stitch at the level of the superficial or deep aponeurosis depending on the thickness of the abdominal walls of the patients. The major difficulty in placing such a suture stitch is in spreading the skin, which is the most superficial part, and then locating the muscle and aponeurosis layer, which is the most rigid tissue, where the suture stitch must be placed and knotted from outside to inside. Surgeons often have difficulties in closing the deep tissue that is the aponeurosis, and in some cases this tissue is not reclosed. In addition, certain complications can develop, such as failure of the deep orifice to heal and to close, leading to evisceration. Another possible complication is strangulation of intraabdominal elements such as the small intestine within this orifice, with the risk of causing intestinal occlusions or other digestive complications.